Analysis of the effectiveness of fine-tuned nursing with nafamostat anticoagulation throughout CRRT in high-risk bleeding patients with severe pneumonia complicated by AKI
CRRT全程萘莫司他抗凝精细化护理在出血高危重症肺炎合并AKI患者中的应用效果分析

摘要

目的 探讨全程精细化护理在行连续性肾脏替代治疗的出血高危重症肺炎合并急性肾损伤患者中的应用效果。方法 选择2024年6月-2025年6月我院收治的135例行连续性肾脏替代治疗的出血高危重症肺炎合并急性肾损伤患者为研究对象，按随机数字表法将其分为对照组（67例）和观察组（68例）。对照组采用常规护理，观察组实施全程精细化护理。对比两组凝血功能指标、管路凝血事件、出血并发症、治疗时间及护理满意度。结果 观察组连续性肾脏替代治疗时间、ICU住院时间及总住院时间均短于对照组（P＜0.05）；观察组管路凝血事件总发生率低于对照组（P＜0.05）；观察组出血并发症总发生率低于对照组（P＜0.05）。结论 全程精细化护理可有效降低行连续性肾脏替代治疗的出血高危重症肺炎合并急性肾损伤患者的管路凝血事件与出血并发症发生风险，缩短治疗时间。

Abstract

Objective To evaluate the effectiveness of comprehensive refined nursing care in high-risk bleeding patients with severe pneumonia complicated by acute kidney injury undergoing continuous renal replacement therapy (CRRT).
Methods A total of 135 patients with severe pneumonia and acute kidney injury at high risk for bleeding who received CRRT at our hospital between June 2024 and June 2025 were selected as study subjects. They were randomly divided into a control group (67 cases) and an observation group (68 cases) using a random number table. The control group received standard nursing care, while the observation group received comprehensive refined nursing care. Comparisons were made between the two groups regarding coagulation function indicators, circuit clotting events, bleeding complications, treatment duration, and nursing satisfaction.
Results The observation group had significantly shorter durations of CRRT, ICU stay, and total hospitalization compared to the control group (P < 0.05). The overall incidence of circuit clotting events was lower in the observation group than in the control group (P < 0.05). Similarly, the overall incidence of bleeding complications was also lower in the observation group (P < 0.05).
Conclusion   Comprehensive refined nursing care effectively reduces the risks of circuit clotting events and bleeding complications in high-risk bleeding patients with severe pneumonia and acute kidney injury undergoing CRRT, and shortens treatment time.